Research Journal of Recent Sciences ________________________________________________E-ISSN 2277-2502
Vol. 5(8), 51-55, August (2016)
Res. J. Recent Sci.
Review Paper
Psidiumguajava (Guava) Leaves as a Potential Treatment of Scurvy
Anurag Mondal
Bankura Sammilani Medical College and Hospital, Bankura-722101, West Bengal, India
[email protected]
Available online at: www.isca.in, www.isca.me
Received 6th May 2016, revised 21st June 2016, accepted 29th June 2016
Abstract
Psidiumguajava(Guava),belonging to the Myrtaceae family, is a well-known food crop in subtropical and tropical countries.
It is also known for its medicinal value and is widely used as folk medicine around the world. The seed, leaves, fruit and bark
of P. guajava tree have been traditionally used for a long time for its medicinal uses that are still in use today. P. guajava is
known for its antioxidant, analgesic & anti-inflammatory, antispasmodic, hepatoprotective, antidiarrheal, anti-diabetic, anticancer activity, antimicrobial and antipyretic properties. Scurvy is a condition (or rather a state)of the human body that
occurs due to dietary deficiency of vitamin C, which is primarily the main cause. Chronic malnutrition is an predisposing
factor and patients who are suffering from it are the main targets and are at a potential risk . The primates lack the enzymes
required to synthesize vitamin C from its precursor. And thus theyhave to supplement Vitamin from exogenous dietary
sources to fulfill their needs. Naturally occurring leaves of Psidiumguajavacan be used as a potential supplement in the
treatment of scurvy. The Leaves of this plant provides the all in one treatment of Scurvy. This Myrtaceae fruit bearing plants
are an interesting group offering definite opportunities for future development of excellent natural remedies one can get for
treatment of variety of diseases.
Keywords: Scurvy, Psidiumguajava Leaves, Vitamin C, Spasmolytic, Analgesic, Anti-inflamatory.
Introduction
Vitamin C is one of the essential nutrients that isneeded for
proper functioning of the body. Primates (including human
beings), guinea pigs, bats, and some species of birds lack the
enzyme gulonolactone oxidase which is needed for the
conversion of gulonolactone to L-ascorbic acid (Vitamin C).
And so it can’t be synthesized in the body and hence it must be
obtained through their diet. Vit. C is a highly active reducing
agent and helps in free radical scavenging. It helps in the
hydroxylation of proline and lysine in protocollagen to form
compounds hydroxylysine and hydroxyproline in mature
collagen.
Scurvy, also known as Moeller’s Disease, is a clinical condition
caused by Vit.C deficiency. Its primary symptoms are-swollen
gums with easy bleeding, perifollicular and petechial
haemorrhages, ecchymoses. Other clinical features arehaemarthrosis, gastrointestinal bleeding manifestations, and
anaemia. Also wound healing is delayed, this is probably due to
reduced collagen synthesis as a result of reduced Vit.C level in
body.
Vit.C rich fruits (Citrus, Guava, etc) are ideal for the prevention
of scurvy. It is usually associated with malnutrition and usually
affects the poor people. Treatment of scurvy is usually a Vit.C
rich diet or a course of 250mg of Vit. C, 3 times a day should be
given. Although prognosis is excellent if treatment is started
early, but if not treated may be fatal.
International Science Community Association
Leaves of guava (Psidiumguajava)can be used as an alternative
for the treatment of scurvy. This plant’s leaves contain various
chemical that can aid in the treatment of scurvy. Guava tree is
abundantly found in the subtropical and tropical regions all over
the globe. Guava fruit is also rich in Vit.C. Although its fruits
are seasonal,but its leaves can be used at any time as these are
evergreen trees that can reach up to a height of 33ft, with
spreading branches. This plant parts was traditionally used a as
natural remedy to a variety of diseases including diarrhea ,
dysentery, inflamed mucous membranes, digestive problems,
edema, gout, hemorrhages, gastroenteritis, gastritis, diabetes.
Observation: Morphology: Guava leaves are oval or oblong
elliptical shaped, 2 to 6 inches long and 1 to 2 inches wide with
an irregular outline. The leaves have short petioles and are
oppositely arranged, that are slightly down on the underside.
Green in appearance with somewhat leathery texture of veins,
this leaves have a pleasant scent.
Guava leaf extract has potent anti-inflammatory, analgesic,
hemostatic, hepatoprotective, antimicrobial, antifungal and
antioxidant activities. The leaf extract contains Vitamin C in
significant amount. They also contain organic compound such
as-monoterpene compounds (α-pinene and β-pinene),
flavonoids, triterpenoids, caryophyllene oxide, caryophyllene.
Menthol, an important analgesic is also present. Along with
itavicularin, quercetin-3-α-L-arabinofuranoside and 3-L-4pyranoside, guaijaverin, guavenoic acid, guajavolide, humulene
51
Research Journal of Recent Sciences ____________________________________________________________E-ISSN 2277-2502
Vol. 5(8), 51-55, August (2016)
Res. J. Recent Sci.
(α-humulene), limonene,cardinene is also present. Others
compounds such as selinene, tannin, resin, isopropyl alcohol,
terpenyl
acetate,
farnesene,
cryptonine,
dihydrobenzophenanthridine,
prenol,
guayavolic
acids,
oleanolic acid, eugenol, longicyclene, nerolidioltriterpene, βbisabolene, curcumene, mallic acids, β-sitosterol, ursolic,
crategolic and cineol1, is also found in trace amounts.
action of menthol indicates that menthol has central analgesic
effects acting through the spinal cord. Pain hypersensitivity
(contralateral as well as ipsilateralpain) is decreased by menthol.
Inflammatory pain is probably inhibited by blockage of voltage
gated Na+ and Ca2+channels9. Hence it can counteract the pain
sensation that is caused by swelled up gums in scurvy and give
relief to the patient.
α-Pinene acts as an anti-inflammatory agent. Experiments by
Nissen and colleagues also proved it to be a broad-spectrum
antibiotic2. It probably is mediated via PGE1.
β-caryophyllene is chemically a natural bicyclic sesquiterpene
compound. It is an important component of oil of
Syzygiumaromaticum (cloves) and many other essential oils.
Clove oil is extracted from its stem and flowers. It has also been
extracted from the leaves ofPsidiumguajava .β-caryophyllene
acts as a local anesthetic , thereby reducing the pain in gums due
to scurvy10.
Vitamin C (Ascorbic acid) is a nutrient and antioxidant
substance. Antioxidant protect cells from the deleterious effect
of free radical and helps to scavenge it. A research was done to
extract the Ascorbic acid in the leaves of Guava by two
methods, in the first method using Ethanol in room temperature
and the yield percentage 15.1%, in the other method soxhlet
extraction was done and the yield percentage 20.7%3. This
indicates that Vit.C is present in considerable amount in this
leaves. And leaf extract can be used as a rich source of Vit.C in
patients with scurvy. Crushed leaves can be taken orally for
better use.
Earlier studies indicated that flavonoids may affect antiinflammatoryeffects. Theycan inhibit reactive oxygen species
along with nitrogen compounds4. Various enzymes such as nitric oxide synthase lipoxygenase or cyclooxygenase ,
exhibitsanti-inflammatoryactivity. It has been proved by various
researches that flavonoids can inhibit these anti-inflammatory
activities and prevent free radical production5 .Hence they act as
anti-oxidants. But it has been earlier proposed that antioxidant
activity of flavonoidsis of negligible amount. Although it has
been observed that after intake of foods rich in flavonoids there
was a considerable hike in the antioxidant potential ofblood.
This discrepancy was later solved by proposing that uric acid, a
metabolic product formed as a result of flavonoid
depolymerization, was the main cause6. Flavonoids alsohave
significant antiproliferative activity. Its effect can be best cited
in a granuloma where they tend to reduce the volume as well as
weight of the granuloma. As it is known that cytokines acts as
an important factor in the formation and sustenanceof
granuloma, so it is quite evident that flavonoids are mainly
responsible
for
this
anti-inflammatory
effect
and
antiproliferative effect7.
Menthol is a natural analgesic compound found in a wide range
of plants.It is also present in significant amount in
Psidiumguajava. It is finds significant use in minor throat
irritation. Opioid analgesics are group of drugs that reduces pain
by acting on opioid receptors (mu, kappa and delta). Menthol is
a kappa opioid receptor agonist(weak) and acts by inhibiting
Ca2+ channels at neuronal membranes .As a result the pain
pathway is blocked. On tropical administration of menthol, the
cold receptors are stimulated and it gives a pleasant cooling
sensation due to this effect8. Result of experiments on central
International Science Community Association
Caryophyllene oxide is a derivative of (−)-β-caryophyllene,also
extracted
from
leaf
extracts.
Experiments
by
Chavan, Wakte, and Shindedemonstrated that caryophyllene
oxide has potent anti-inflammatory and analgesic activity11.
Humulene
(α-humulene)
is
a
naturally
occurring
monocyclic sesquiterpene. It is constituent of Guava leaves
extract. It produces similar effects to dexamethasone12. Recent
studies have found outthat the Cordiaverbenacea's essential oil,
α-humulenehas anti-inflammatory properties. Experimental
animal models of rats and mice having inflammation, responded
well to oral treatment.α-humulene can also reduce platelet
activating factors. Edema(caused by histamine injection) was
also reduced by alpha humulene. Significant results were found
out when in it was used for systemic treatment in experimental
rats (injected with carrageenan). Interleukin-1β (IL-1β) and
tumornecrosis factor- α were markedly reduced. This compound
was also found to reduce various other factors including
prostaglandins E2 (PGE2). Along with it, it alsoreduced the
expression of various enzymes including cyclooxygenase and
nitric oxide synthase (iNOS).So it is quite evident that this
compound is a potential anti-inflammatory agent. Surprisingly
animals treated with dexamethasoneshowed similar pattern of
activity13.
Avicularin (quercetin-3-α-L-arabinofuranoside) is another
important compound found in the leaf extract. Avicularinhas
anti infectious and anti-inflammatory properties. Studies
revealed that synthesis of inducible nitric oxide synthase as well
as cyclooxygenase is reduced by avicularin .So as a result nitric
oxide and prostaglandins, which are proinflammatory mediators
are reduced. Hence inflammatory responses can’t be generated.
Another factor NF-κB is responsible for production of
proinflammatorycytokines, it acts by activating genes in the
nuclues. But LPS-induced degradation of IκB, which is
responsible for cytoplasmic retention of NF-κB, is suppressed
by avicularin. As a result the inflammatory cytokines are
reduced producing a marked anti-inflammatory action14.
The spasmolytic activity of the Psidiumguajavaleaf has been
shown experimentally. Quercetin, aaglyconepresent in the leaf
52
Research Journal of Recent Sciences ____________________________________________________________E-ISSN 2277-2502
Vol. 5(8), 51-55, August (2016)
Res. J. Recent Sci.
and in the extract, gets activated on hydrolysation by
gastrointestinal fluid15. Oral administration of the leaf extract is
effective in producing mark spasmolytic action.
microorganisms that may invade the already injured gums and
teeth.
Methodology
Jaiarj, Wongkrajang, Thongpraditchote, Peungvicha, Bunyaprap
hatsara and Opartkiattikul experimented on the bleeding time
and hemostasis property of guava leaf extract. Hemostasis
involves three vital components vasodilatation, platelet
aggregation and coagulation of blood. In vivo models showed
that dosage of guava leaf extract is directly proportional to the
amount of platelet aggregation occurred. Increase in amount of
leaf extract increases its effect.Also vascular tissue of animal
models (rabbit) earlier treated with phenylephrine, showed
marked vasoconstriction on application of this extract. All this
factors proved to be beneficial but further experiments revealed
counter
mechanism.
Blood
coagulation
time
was
considerablyincreased. Rise in APTT (activated partial
thromboplastin time )(p<<0.05)was directly proportional to the
amount of extract given. Bleeding time was unaffected 16.
Although guava leaf extract may not be a complete hemostatic
agent (as it prolongs coagulation time) but still others beneficial
effects give it a minor hemostaticproperty. Platelet aggregation
and vasoconstriction may be able to control minor bleeding
manifestations in scurvy which will be a beneficial effect to
ascorbic acid which has the major role.
Guaijaverin (quercetin-3-O-α-L-arabinopyranoside) is an active
flavonoid compoundfound in guava leaves. It has antiplaque
property. The growth of bacteria Streptococcus mutans was
inhibited by guaijaveri17. Plaque is an important factor that is to
be considered in scurvy. It can further complicate the disease by
invading the swollen gums, which act as potential breeding
grounds for microorganisms and causing secondary dental
problems. This leaf extract acts by inhibiting growth of other
microorganism on the inflamed gums and teeth and prevents it
from getting further complicated. Hence plaque cannot get
deposited on the teeth and they are saved from further damage.
Guava Leaves Extract has antimicrobial activity. Birdi et al. and
Birdi et al.stated that P. guajava leaves can be effective in
treating diarrhea as it has a broad spectrum of antimicrobial
action18. Flavonoids which is an active component of this leaf is
primarily responsible for this antimicrobial activity.
Experiments by H.ARIMA & DANNO on guava leaf extract
have revealed four flavonoids quercetin ,guaijavarin, morin-3O-α-L-lyxopyranoside , morin-3-O-α-L-arabopyranoside that
has potent antimicrobial action19.Guava leaf extract also
suppressed growth of a gram positive bacteria(including
Staphylococcus aureus andBacillus cereus).Antimicrobial
effects of guava leaves was further pronounced by experiments
that showed that extract prepared from dry leaves was effective
in inhibiting the growth of β-streptococcus group A bacteria20.
So it is quite evident that the leaf extract contain antimicrobial
agents that can be made use of in treating microbial diseases.
These leaf extracts when used in scurvy treatment has double
beneficial effects, apart from providing Vit.C (which treats the
main cause),it is also providing protection against various
International Science Community Association
My present study emphasize the various important medicinal
property of guava leaves and its usefulness in the treatment of
scurvy. Various research have been previously done on this
species to demonstrate its various properties. Fruits, seeds and
leaves all have been extensively studied. Experiments have been
done to reveal the various chemicals this leaves contain. Also
the pharmacological and pathophysiological properties of this
leaves are being extensively studied. All these studies and
research aided me on this research and provided valuable
information.
Scurvy as a disease mainly prevails because of the deficiency
of Vitamin C in the diet, which is one of the essential
micronutrients that is needed for proper functioning of body.
This plant which is a good source of vitamin C is also a good
source of other chemicals that aid in the treatment of this
dreadful disease. All these factors add up to prove the
qualitative treatment this plant might have in the treatment of
scurvy. Much needed chemical trials and other research is
needed to ascertain its utility. But theoretically it is quite
efficient. Also individual research work done for the various
components of this leaves proved to be quite beneficial.
Results and Discussion
Various results indicate that Psidiumguajava leaves extract is
providing an excellent treatment in Scurvy. Although few
pathophysiological action of its is still in a hazy state. This plant
has extreme potential to be a source of natural remedies to a
number of diseases. Although scurvy is not much common these
days due to proper dietary plans implementation. But it still
prevails in developing countries. Malnutrition is the major cause
of it. Usually it is accompanied by marasmus and other
nutritional deficient diseases. Guava plant is quite common is
tropical regions. Its fruit is a rich source of Vitamin C and
dietary fibers. Also it as a good source of calcium,vitamin A,
iron ,manganese , malic acids, oxalic acid, saponin, flavonoids,
phosphoric acid, quercetin, guaijavarin. Also its seed contains
various essential oils. The leaves are equally valuable and can
be used as an immediate remedy as it available the whole year
round, not like the fruits which is seasonal.
It is a good source of Ascorbic acid that helps to recover from
scurvy. It is also a good antimicrobial agent and antiplaque
agent, that protects the gums from getting infected during the
recovery phase of the patient. Bleeding manifestation in the
form
of
gum
bleeding,
petechichial
and
perifolicularhemorrhages, gastrointestinal bleeding is seen.
Platelet aggregation and vasoconstriction effect of Guava leaf
extract can be used to preventthese bleeding manifestations.
Also if these bleeding manifestaions are controlled then anaemia
53
Research Journal of Recent Sciences ____________________________________________________________E-ISSN 2277-2502
Vol. 5(8), 51-55, August (2016)
Res. J. Recent Sci.
due to blood loss will be automatically corrected.P.guajava
leaves also has analgesic, anesthetic and spasmolytic action,
which helps to get relief from pain.
P.guajava leaves also has a potent antioxidant activity which
helps to protect the cells from reactive free radicals.Also they
have anti inflammatory effects that may be helpful in control of
haemathrosis. They also have anti diabetic, anti diarrheal
property.It is also hypoglycemic agent so it has double benefits
in case of controlling obesity related diabetes reducing both
weight and also acting against diabetes. They have
hepatoprotective action and hence can be used as a liver tonic in
jaundice .It is currently being researched for its anti-cancer
properties. Traditionally they have been used in the treatment of
malaria, as a oral care agent and in the control of vaginal
odours.
Conclusion
Nature is the treasure house of medicines. Cure of every disease
lies in nature itself. This plant Psidiumguajava of Myrtaceae
family are an interesting group offering definite opportunities
for future development of excellent natural remedies one can get
for treatment of variety of diseases.Every part of this plant has
immense medicinal value.Its fruit, flowers, seeds, leaves all
have its own medicinal value.This study provides only a
glimpse of the potency of this plant to cure scurvy and its
pharmacological properties. Evidence suggests P. guajava can a
be a great natural remedy for the treatment of various diseases
and only the seeds of time can provide it be likewise.
References
1.
Joseph Baby and M. Priya (2011). Review on nutritional,
medicinal and pharmacological properties of guava
(Psidiumguajava Linn.). International Journal of pharma
and bio sciences, 2(1), 53-69.
2.
Nissen L, Zatta A, Stefanini I, Grandi S, Sgorbati B and
Biavati B, et al. (2010). Characterization and antimicrobial
activity of essential oils of industrial hemp varieties
(Cannabis
sativa
L.).
Fitoterapia, 81,
413419. doi:10.1016/j.fitote.2009.11.010.
3.
Muatasim Nusiba, Rzaz Adel Farouk and Wiaam Esam
Eldeen (2015). Extraction of Ascorbic Acid “Vitamin C”
From PsidiumGuajava Leaves in Different Conditions.
Sudan university of Science and Technology, Sudan.
4.
Izzi V, Masuelli L, Tresoldi I, Sacchetti P, Modesti A,
Galvano F and Bei R (2012). The effects of dietary
flavonoids on the regulation of redox inflammatory
networks. Frontiers
in
bioscience
(Landmark
edition), 17(7),
23962418. doi:10.2741/4061. PMID 22652788.
5.
Gomes A, Couto D, Alves A, Dias I, Freitas M, Porto G,
Duarte JA and Fernandes E (2012). Trihydroxyflavones
with
antioxidant
and
anti-inflammatory
International Science Community Association
efficacy. BioFactors, 38(5),
386. doi:10.1002/biof.1033. PMID 22806885.
378-
6.
Lotito SB and Frei B (2006). Consumption of flavonoidrich foods and increased plasma antioxidant capacity in
humans: cause, consequence, or epiphenomenon?. Free
Radic.
Biol.
Med., 41(12),
1727–
46. doi:10.1016/j.freeradbiomed.2006.04.033.PMID 17157
175.
7.
Dutta Sarmistha and Swarnamoni Das(2010). A study of
the anti-inflammatory effect of the leaves of
Psidiumguajava
Linn.
on
experimental
animal
models. Pharmacognosy research, 2(5), 313.
8.
Galeotti Nicoletta, et al (2002). Menthol: a natural
analgesic compound. Neuroscience letters, 322(3), 145148.
9.
Pan R, Tian Y, Gao R, Li H, Zhao X, Barrett JE and Hu H
(2012). Central mechanisms of menthol-induced analgesia.
J Pharmacol Exp
Ther., 343(3), 661-72. doi:
10.1124/jpet.112.196717. Epub.
10. Ghelardini C, Galeotti N, Di CesareMannelli L, Mazzanti
G and Bartolini A (2001). Local anaesthetic activity of
beta-caryophyllene. Farmaco, 56(5-7),
387-389.,
doi:10.1016/S0014-827X(01)01092-8. PMID 11482764.
11. M.J. Chavan, P.S. Wakte and D.B. Shinde (2010).
Analgesic and anti-inflammatory activity of Caryophyllene
oxide from Annonasquamosa L. bark. Phytomedicine,
17(2), 149-151.
12. Passosa G.F and Fernandesa ES. et al. (2007). Antiinflammatory and anti-allergic properties of the essential oil
and active compounds from Cordia verbenacea. Journal of
Ethnopharmacology, 110(2),
323333. doi:10.1016/j.jep.2006.09.032.
13. Elizabeth S. Fernandes, Giselle F. Passos, Rodrigo
Medeiros, Fernanda M. da Cunha, Juliano Ferreira, Maria
M. Campos, Luiz F. Pianowski and João B. Calixto (2007) .
Anti-inflammatory effects of compounds alpha-humulene
and (−)-trans-caryophyllene isolated from the essential oil
of Cordia verbenacea. European Journal of Pharmacology,
569(3), 228-236.
14. Van Jae-Won Lee, Ji-Eun Chang, Ji-Young Kim, Nam-Ho
Kim, Hee
Jae
Lee, Sung-Soo
Kim, Wanjoo
Chun and Yong-Soo Kwon (2012). Avicularin Inhibits
Lipopolysaccharide-Induced Inflammatory Response by
Suppressing ERK Phosphorylation in RAW 264.7.
Macrophages. Biomol & Ther (Seoul)., 20(6), 532-537.
doi: 10.4062/biomolther.2012.20.6.532.
PMCID: PMC3762284.
15. Lozoya Xavier et. al. (1993). Quercetin glycosides in
Psidiumguajava L. leaves and determination of a
spasmolytic principle. Archives of medical research, 25(1),
11-15.
54
Research Journal of Recent Sciences ____________________________________________________________E-ISSN 2277-2502
Vol. 5(8), 51-55, August (2016)
Res. J. Recent Sci.
16. Jaiarj P., Wongkrajang Y., Thongpraditchote S.,
Peungvicha P., Bunyapraphatsara N. and Opartkiattikul N.
(2000).
Guava
leaf
extract
and
topical
haemostasis. Phytotherapy Research, 14(5), 388-391.
17. Prabu G. R., A. Gnanamani and S. Sadulla (2006).
Guaijaverin–a plant flavonoid as potential antiplaque agent
against Streptococcus mutans. Journal of Applied
Microbiology, 101(2), 487-495.
18. Birdi Tannaz et al (2010). Newer insights into the
mechanism of action of Psidiumguajava L. leaves in
infectious diarrhoea. BMC complementary and alternative
medicine, 10(1), 33.
International Science Community Association
19. Hidetoshi ARIMA and Gen-ichi DANNO (2002). Isolation
of
Antimicrobial
Compounds
from
Guava
(Psidiumguajava L.) and their Structural Elucidation.
Bioscience, Biotechnology, and Biochemistry., 66(8).
DOI:10.1271/bbb.66.1727.
20. Dhiman A, Nanda A, Ahmad S and Narasimhan B
(2011). In vitro antimicrobial activity of methanolic leaf
extract of Psidiumguajava L. J Pharm BioalliedSci, 3, 226229.
55